The Effect of Aqueous Humor on the Growth of Subconjunctival Fibroblasts in Tissue Culture and Its Implications for Glaucoma Surgery

Herschler, Jonathan; Claflin, Alice J.; Fiorentino, Gilbert

doi:10.1016/0002-9394(80)90118-x

Cited by 93 publications

(26 citation statements)

References 6 publications

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“…The aqueous humor has been suggested to play a role in the failure of maintenance of filtering blebs (Herschler et al 1980;Joseph et al 1989). Molteno et al (1976) claimed that the inflammatory reaction around the implant, between 6 and 12 weeks after operation, was caused by aqueous humor.…”

mentioning

confidence: 99%

Outcome of Molteno implantation surgery in refractory glaucoma and the effect of total and partial tube ligation on the success rate

Välimäki

Tuulonen

1998

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To analyze the results of 87 consecutive one-stage Molteno implantations in 87 patients and evaluate the factors influencing the surgical outcome, especially the effect of intraoperative partial and total occlusion of the tube. Methods: Successful outcome was defined as final intraocular pressure (IOP) between 6 and 22 mmHg with less or equal amount of glaucoma medication than preoperatively without loss of light perception. Results: After a mean (∫SD) follow-up of 24∫17 months, the mean IOP was 18.1∫16.0 mmHg compared to the preoperative mean of 42.4∫11.1 mmHg (p∞.0001). One-, 2-and 4.5-year life-table success rates were 90%, 75% and 50%, respectively. There was no statistically significant difference in the success rate between the eyes with total and partial tube occlusion (pΩ0.703). Postoperative hyphema, suprachoroidal hemorrhage and the number of systemic medications were the only factors significantly associated with failure. Conclusions: Molteno implantation is warranted in patients with refractory glaucoma who have undergone numerous previous surgical procedures.

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confidence: 99%

Outcome of Molteno implantation surgery in refractory glaucoma and the effect of total and partial tube ligation on the success rate

Välimäki

Tuulonen

1998

Acta Ophthalmologica Scandinavica

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“…The growth of subconjunctival fibroblasts may be influenced by inhibiting factors in the aqueous humor [19,20,21,37]. 5-Fluorouracil (5-FU) is a strong inhibitor of fibroblast proliferation.…”

Section: Discussionmentioning

confidence: 99%

Glaucoma filtering surgery, a retrospective study of 300 operations

Veldman

Greve

1987

Doc Ophthalmol

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The results of 300 consecutive glaucoma filtering procedures, which were performed in our clinic between January 1982 and September 1985, are described. The overall combined success rate (complete + qualified) was 66.5% (Heuer's classification). This is in good agreement with other glaucoma referral centers. The peak of the age distribution curve at the time of operation was between 70 and 75 years. Nevertheless, 30% of operations was performed on patients under 50 years of age. Relatively poor success rates were obtained in operations following prior unsuccessful filtering surgery (50.5%) or other surgery (47%), in patients under 50 years of age (61%) and in some types of secondary glaucoma. In aphakia/pseudophakia the success rate was 33%. The posterior capsule was intact only 13% of this category at the time of surgery, in 56% previously unsuccessful filtering surgery had been performed, and the age at operation was relatively young (53 yr). These factors have an unfavorable influence on the results of filtering surgery. The success rate in phakic primary open angle glaucoma was 85% and in phakic primary angle closure glaucoma 73%. The combination with a cataract extraction (in 28%) and a peripheral iridectomy, if this had not been performed previously, (in 31%) may have contributed to the relatively favorable surgical results in phakic primary angle closure glaucoma. Relatively high intraocular pressures were found in the early postoperative period; the peak of the pressure-curve was between 20 and 25 mm Hg, 10 mm Hg higher than at the end of follow-up. Postoperative progression of glaucomatous visual field defects was noted in 7%. The most disturbing complication was flat anterior chamber, causing or enhancing cataract formation (in 4 out of 8 phakic patients) and corneal dystrophy (in 2 out of 12 patients). A review of literature is given concerning methods of improving filtration, when the surgical prognosis is poor.

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“…Hypotony is not desirable because o f the inhibitory ef fect of the aqueous on the behavior of fibroblasts derived from Tenon's capsule [14] hypertensive phase may contribute to successful control of IOP [13], Seven patients developed an IOP greater than 21 mm Hg during the early postoperative period, despite the stated opening pressure of the valve (14 mm Hg). All these patients were noted to have fibrinous uveitis concurrent with high IOP.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Results of Krupin-Denver Valve Implants in Filtering Surgery for Neovascular Glaucoma

Mastropasqua

Carpineto²,

Ciancaglini³

et al. 1996

Ophthalmologica

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The long-term results obtained with the Krupin eye short valve shunt in 28 eyes with neovascular glaucoma were retrospectively analyzed by means of Kaplan-Meier survival curve. The preoperative intraocular pressures (IOPs) ranged from 28 to 62 mm Hg (mean, 36.8 ± 5.8 mm Hg). Success was considered an IOP of less than 22 mm Hg and greater than 5 mm Hg without medication (complete success) or with medication (qualified success) without additional glaucoma filtering surgery or devastating complications. Postoperative success was obtained in 10 out of 28 eyes after a mean follow-up period of 58.4+23.02 months (range, 10-108 months). The 3- and 6-year life table success rates were 66 and 34%, respectively. Early complications were: shallow or flat anterior chamber (15 patients, 53.6%), hypotony (16 patients, 57.1%), hypertony (7 patients, 25%), serous choroidal effusion (7 patients, 25%), fibrinous uveitis (5 patients, 17.9%), blockage of the intracameral portion of the tube by fibrin (5 patients, 17.9%), choroidal hemorrhage (2 patients, 7.1%). Late complications were: external conjunctival bleb failure (12 patients, 42.9%), blockage of the intracameral portion of the tube by fÍbrovascular tissue (5 patients, 17.9%), cataract (2 patients, 7.1%), bullous keratopathy (2 patients, 7.1%), external erosion of the Silastic valve (2 patients, 7.1%), phthisis bulbi (2 patients, 7.1%). Mortality during long-term follow-up was high in our series. The complications of an underlying diabetes mellitus were the most common causes of death (15 out of 22 patients). The high mortality of patients subjected to valve implantation makes it difficult to interpret the results of long-term studies. However, the valve implant is still today an alternative surgical procedure for controlling IOP in eyes with neovascular glaucoma that have visual potential.

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The Effect of Aqueous Humor on the Growth of Subconjunctival Fibroblasts in Tissue Culture and Its Implications for Glaucoma Surgery

Cited by 93 publications

References 6 publications

Outcome of Molteno implantation surgery in refractory glaucoma and the effect of total and partial tube ligation on the success rate

Outcome of Molteno implantation surgery in refractory glaucoma and the effect of total and partial tube ligation on the success rate

Glaucoma filtering surgery, a retrospective study of 300 operations

Long-Term Results of Krupin-Denver Valve Implants in Filtering Surgery for Neovascular Glaucoma

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